Group Health Insurance is available on a guarantee to issue basis in every state per health reform laws that were passed in 1996. (*HIPAA) Although plans are available, pricing can vary by as much as 5x depending on your group size and State of primary operation. In Illinois the maximum load factor is 67%. In Indiana it is 85%. Not all carriers underwrite identically.
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HIPAA encompasses those who get their insurance through their employer and those who purchase their own insurance in the individual market. First, the law limits the extent to which insurance plans may exclude pre-existing conditions. Generally, that period is 12 months, and this period can be imposed on a person with continuous coverage only once. That means that if a person is insured for eight months under one employer, and then gets a new job, the coverage under the new plan may exclude coverage for a pre-existing condition for an additional four months only. From that time on, if coverage is continuous, the person will never have to satisfy another pre-existing-condition exclusion period.

Second, HIPAA requires group health plans to cover all eligible employees, regardless of health status. This means that a health insurance carrier must agree to provide coverage for all employees, period. If a person has satisfied the 12-month exclusion period,the new plan cannot impose a new exclusion period.

Third, HIPAA extends coverage guarantees to those leaving group plansand seeking coverage in the individual market. If a person has had 18 months of previous, qualifying coverage, has exhausted any COBRA continuation benefits that were available, and has not had a break in coverage exceeding 62 days, he or she can purchase an individual plan on a guaranteed-issue basis. The states have created their own mechanisms to implement this right to guaranteed issue. Most states have chosen to implement a choice of two health plans, either through private insurance carriers, or through a public rganization known as a risk pool. Some states have chosen to limit the amount of premium that must be paid, and some risk pools offer the most affordable premiums.

Employers may impose a waiting period, which is different from the12-month pre-existing condition exclusion period. A waiting period is the period of time before which employees are not eligible for some benefits, such as pension, life insurance and health insurance. In this case, an employee will want to continue COBRA coverage or, if that coverage is exhausted, seek coverage in the individual market. When the waiting period expires, however, the employer may not impose a new12-month exclusion period.A person with existing medical conditions would normally have trouble getting coverage.

As long as a person is under COBRA continuation coverage, there is no guarantee of coverage in the individual market. Once that coverage is exhausted, though, coverage in the individual market is guaranteed. If there is confusion over the requirements of a new employer's plan, a person should obtain coverage requirements from the new employer, including waiting periods and health plan descriptions. The person should also contact a consumer affairs representative at the state department of insurance.